Effect of atorvastatin on cognitive functions in patients with chronic brain ischemia and metabolic syndrome

The aim of the study was to assess the cognitive function in patients with chronic brain ischemia and metabolic syndrome (MC ) during the treatment of hyperlipidemia with atorvastatin. We examined 300 patients with dyscirculatory encephalopathy (DE) and MS aged 48–85 years. All patients were assigned into two groups: main — atorvastatin users (n=113; of which 40 were in middle age, 61 — in old age, 12 — senile) and the control group — non-users of any statin (n=187, of which 63 were in middle age, 104 — in old age, 20 — senile). Mini Mental State Examination (MMSE) and other neuropsychological tests were used to assess the cognitive functions of patients. According to the results of the MMSE and other neuropsychological tests, there was no statistically significant difference in cognitive status and severity of the cognitive impairment between patients of main and control groups. The positive correlation was found between the duration of atorvastatin intake and MMSE total score in patients with DE and MC, that could mean a positive effect of longer atorvastatin therapy on cognitive functions. When the data of different age groups was analyzed separately, it was detected the significant correlation between the duration of atorvastatin intake and MMSE total score only in old age patients with DE and MC, but not in middle age and senile patients.

Key words: cognitive functions, treatment with atorvastatin, metabolic syndrome.

Published: 31.01.2017

References:

• Bachinskaya N.Yu. (2011) Lechenie bolezni Altsgeymera: sovremennyie vozmozhnosti i perspektivyi. NeyroNEWS: psihonevrologiya i neyropsihiatriya, 2/1: 14–23.
• Bogdanov A.R., Bogdanov R.R., Mazo V.K., Feofanova T.B. (2015) Kognitivnyie narusheniya pri distsirkulyatornoy entsefalopatii i ozhirenii. Consilium medicum, 15(2): 46–51.
• Damulin I.V., Zaharov V.V. (2003) Distsirkulyatornaya entsefalopatiya: metod. rekomendatsii. Pod red. N.N. Yahno. Moskva, 32 s.
• Zaharov V.V., Yahno N.N. (2005) Kognitivnyie rasstroystva v pozhilom i starcheskom vozraste. Metod. posobie dlya vrachey, Moskva, 71 s.
• Malev A.L., Tovazhnyanskaya E.L., Zaharova A.N., Kaliberdenko V.B. (2014) Sravnitelnyiy psihometricheskiy analiz kognitivnyih rasstroystv vsledstvie sosudistyih zabolevaniy golovnogo mozga. Medichna psihologIya, 9/1(33): 111–116.
• Mitchenko O.I., Karpachov V.V. (red.) (2011) Diahnostyka i likuvannia metabolichnoho syndromu, tsukrovoho diabetu, prediabetu i sertsevo-sudynnykh zakhvoriuvan: rekomendatsii asotsiatsii kardiolohiv Ukrainy ta asotsiatsii endokrynolohiv Ukrainy. U kn.: Sertsevo-sudynni zakhvoriuvannia. Rekomendatsii z diahnostyky, profilaktyky ta likuvannia. Za red. Kovalenko V.M., Lutai M.I., MORION, Kyiv, s. 68–79.
• Alberti K.G., Eckel R.H., Grundy S.M. et al. (2009) Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation, 120(16): 1640–1645.
• Bettermann K., Arnold A.M., Williamson J. et al. (2012) Statins, risk of dementia, and cognitive function: secondary analysis of the ginkgo evaluation of memory study. J. Stroke Cerebrovasc. Dis., 21(6): 436–444.
• Carlsson C.M., Nondahl D.M., Klein B.E. et al. (2009) Increased athe­rogenic lipoproteins are associated with cognitive impairment: effects of statins and subclinical atherosclerosis. Alzheimer Dis. Assoc. Disord., 23(1): 11–17.
• Ciobica A., Padurariu M., Bild W., Stefanescu C. (2011) Cardiovascular risk factors as potential markers for mild cognitive impairment and Alzheimer’s disease. Psychiatr. Danub., 23(4): 340–346.
• Corrao G., Ibrahim B., Nicotra F. et al. (2013) Long-term use of statins reduces the risk of hospitalization for dementia. Atherosclerosis, 230(2): 171–176.
• Folstein M.F., Folstein S.E., McHugh P.R. (1975) «Mini-mental state». A practical method for grading the cognitive state of patients for the clinician. J. Psychiatr. Res., 12(3): 189–198.
• Gu P., Wang J., Shao J.Q. et al. (2010) Effects of atorfastatin on the cognitive function of patients with vascular cognitive impairment and different apolipoprotein E genotypes. Nan Fang Yi Ke Da Xue Xue Bao, 30(3): 512–514.
• Kim J.H., Go S.M., Seo S.W. et al. (2015) Survival in Subcortical Vascular Dementia: Predictors and Comparison to Probable Alzheimer’s Disease in a Tertiary Memory Clinic Population. Dement. Geriatr. Cogn. Disord., 40(3–4): 210–221.
• Komulainen P., Lakka T.A., Kivipelto M. et al. (2007) Metabolic syndrome and cognitive function: a population-based follow-up study in elderly women. Dement. Geriatr. Cogn. Disord., 23(1): 29–34.
• Macedo A.F., Taylor F.C., Casas J.P. et al. (2014) Unintended effects of statins from observational studies in the general population: systematic review and meta-analysis. BMC Med., 12: 51.
• Mandas A., Congiu M.G., Abete C. et al. (2014) Cognitive decline and depressive symptoms in late-life are associated with statin use: evidence from a population-based study of Sardinian old people living in their own home. Neurol. Res., 36(3): 247–254.
• McGuinness B., Craig D., Bullock R. et al. (2014) Cochrane Database Syst. Rev., 7: CD007514.
• McGuinness B., Craig D., Bullock R., Passmore P. (2009) Statins for the prevention of dementia. Cochrane Database Syst. Rev., 2: CD003160.
• McGuinness B., Craig D., Bullock R., Passmore P. (2016) Statins for the prevention of dementia. Cochrane Database Syst. Rev., 4(1): CD003160.
• Mielke M.M., Zandi P.P., Sjögren M. et al. (2005) High total cholesterol levels in late life associated with a reduced risk of dementia. Neurology, 64(10): 1689–1695.
• Ostrowski S.M., Wilkinson B.L., Golde T.E., Landreth G. (2007) Statins reduce amyloid-beta production through inhibition of protein isoprenylation. J. Biol. Chem., 282(37): 26832–26844.
• Panza F., Solfrizzi V., Logroscino G. et al. (2012) Current epidemiological approaches to the metabolic-cognitive syndrome. J. Alzheimers Dis., 30(Suppl. 2): S31–S75.
• Parmenter B.A., Denney D.R., Lynch S.G. (2003) The cognitive performance of patients with multiple sclerosis during periods of high and low fatigue. Mult. Scler., 9(2): 111–118.
• Petersen R.C. (2004) Mild cognitive impairment as a diagnostic entity. J. Intern. Med., 256(3): 183–194.
• Sparks D.L., Kryscio R.J., Connor D.J. et al. (2010) Cholesterol and cognitive performance in normal controls and the influence of elective statin use after conversion to mild cognitive impairment: results in a clinical trial cohort. Neurodegener. Dis., 7(1–3): 183–186.
• Steenland K., Zhao L., Goldstein F.C., Levey A.I. (2013) Statins and cognitive decline in older adults with normal cognition or mild cognitive impairment. J. Am. Geriatr. Soc., 61(9): 1449–1455.
• Swiger K.J., Manalac R.J., Blumenthal R.S. et al. (2013) Statins and cognition: a systematic review and meta-analysis of short- and long-term cognitive effects. Mayo Clin. Proc., 88(11): 1213–1221.
• Tamaoka A. (2016) Dyslipidemia and Dementia. Brain Nerve, 68(7):737–742.
• Tsai C.K., Kao T.W., Lee J.T. et al. (2016) Increased risk of cognitive impairment in patients with components of metabolic syndrome. Medicine (Baltimore), 95(36): e4791.
• van Vliet P. (2012) Cholesterol and late-life cognitive decline. J. Alzheimers Dis., 30(2): S147–162.
• Wang H.L., Wang Y.Y., Liu X.G. et al. (2016) Cholesterol, 24-hydroxycholesterol, and 27-hydroxycholesterol as surrogate biomarkers in cerebrospinal fluid in mild cognitive impairment and Alzheimer’s disease: a meta-analysis. J. Alzheimers Dis. 51(1): 45–55.
• Whitmer R.A., Sidney S., Selby J. et al. (2005) Midlife cardiovascular risk factors and risk of dementia in late life. Neurology, 64(2): 277–281.
• Xia W., Zhang B., Yang Y. et al. (2015) Poorly controlled cholesterol is associated with cognitive impairment in T2DM: a resting-state fMRI study. Lipids Health Dis., 14: 47.